A community-centered intervention to improve infant feeding practices among Pakistani and Bangladeshi families living in the UK

母乳喂养被认为是喂养婴儿的最佳方式。与奶瓶喂养的婴儿相比，母乳喂养时间较长的婴儿严重感染、婴儿猝死的风险较低，儿童时期超重的可能性也较小。延长母乳喂养时间也有助于降低母亲患癌症的风险。英国是世界上母乳喂养率最低的国家之一，只有不到1%的母亲按照世界卫生组织的建议进行纯母乳喂养，直到6个月。大多数母乳喂养方案或额外的母乳喂养支持针对的是被认为最需要母乳喂养支持的弱势白人母亲，而对被认为母乳喂养率相对较高的少数族裔母亲的关注要少得多。在研究母乳喂养率(或其他健康行为)时，印度、巴基斯坦和孟加拉国血统的母亲通常被归为一个“南亚”群体，从这个角度来看，她们的母乳喂养率似乎相对较高。然而，我们最近的研究将这些群体分开，并发现来自巴基斯坦和孟加拉国社区的婴儿比来自印度社区的婴儿更不可能接受母乳喂养。这意味着，巴基斯坦和孟加拉国社区的家庭很容易受到有关母乳喂养和配方奶喂养的错误信息的影响，这可能会对这些社区的健康产生重大影响。研究表明，在这些社区中有一些特定的文化信仰和做法，可能有害于成功地开始和维持母乳喂养，或可能鼓励早期断奶。这意味着需要采取具体的干预措施，敏感地处理这些社区特有的信仰和做法。为了成功地改变被认为是社会规范的做法，需要一种让社区参与并与他们合作制定适当战略的方法。在这个项目中，我们将使用一种新的、以社区为基础的方法来干预发展(替代方法)，这种方法是为了解决女性生殖器切割或其他由社会或文化规范驱动的做法而开发的。我们将在目标社区举办参与活动，并招聘六名社区研究协调员，他们将帮助我们接近研究参与者，并在一系列13个工作坊中促进与他们的沟通。每个研讨会将讨论研究的一个感兴趣的领域，讨论社会规范和信仰，并讨论改变行为的机会。我们将在为卫生和社区从业者举办的三个研讨会上介绍这项研究的结果，并邀请他们讨论他们与目标社区合作的资源和培训需求。然后，我们将开发一个资源工具包(包括关键消息、图像、信息图表和用户手册，有几种语言版本)，供社区和医疗从业者使用，使他们能够提供文化敏感信息和支持。

Breastfeeding is known to be the best way to feed an infant. Compared to bottle-fed babies, those who are breastfed for longer have a lower risk of serious infections, sudden infant death, and are less likely to become overweight as children. Breastfeeding longer also helps to reduce the risk of maternal cancers. The UK has one of the lowest rates of breastfeeding in the World, with less than 1% of mothers exclusively breastfeeding until 6 months as recommended by the World Health Organisation. Most programmes or extra support for breastfeeding are targeted at disadvantaged, white mothers, who are thought to be most in need of breastfeeding support, and much less attention has been paid to mothers from ethnic minorities who are thought to have relatively high rates of breastfeeding. Mothers of Indian, Pakistani and Bangladeshi origin are often grouped together as one 'South Asian' group when looking at breastfeeding rates (or other health behaviours), and when viewed this way it appears that their breastfeeding rates are relatively high. However, our recent research has separated these groups and has identified that infants from Pakistani and Bangladeshi communities are much less likely to be breastfed than infants from Indian communities. This means that families from the Pakistani and Bangladeshi communities have been left vulnerable to misinformation about breastfeeding and formula feeding and this could have significant consequences for the health of these communities. Research has shown that there are specific cultural beliefs and practices in these communities that may be harmful to successful initiation and maintenance of breastfeeding or might encourage early weaning. This means that a specific intervention is required which sensitively addresses the beliefs and practices unique to these communities. In order to successfully change practices that are considered social norms, an approach is required which engages the community and works with them to develop appropriate strategies. In this project we will employ a novel, community-based method to intervention development (the REPLACE approach) which has been developed to tackle female genital mutilation or other practices which are driven by social or cultural norms. We will host engagement events in the target communities and recruit six 'community research facilitators' who will help us to approach research participants and facilitate communication with them in a series of 13 workshops. Each workshop will address an area of interest to the research, discuss social norms and beliefs and discuss opportunities for behaviour change. We will present the outcomes of this research in three seminars for health and community practitioners and invite them to discuss their resource and training needs for working with the target communities. We will then develop a toolkit of resources (including key messages, images, infographics, and a user manual, available in several languages) that can be used by community and healthcare practitioners to enable them to offer culturally sensitive information and support.